A question recently asked by an applicant whose primary interest was anesthesia residency was how to obtain additional experiences and possibly observership in anesthesia?
1. Try for publicly announced observership opportunities
a. MD Anderson Cancer Research Center/University of Texas Houston, Texas, (link)
b. Cleveland Clinic, Cleveland, OH (link)
c. Drexel University, Philadelphia PA (link)
d. Massachusetts General Hospital, Boston MA (link)
e. University of Florida, Gainesville (link)
These are publicly announced programs and thus have a high visibility. This translates into a higher competition for the few spots that are offered. The programs that offer such positions have a well-established curriculum and defined guidelines. Most of them require fees (example 500$ a week at MD Anderson) but will have a structure to the learning experience. Didactic and practical training may be both covered.
2. Try for unannounced observership opportunities – cold calling physicians in anesthesia. This is the underbelly of the observership beast. A large segment of potential opportunities exist but since they are not officially announced information is usually word of mouth. For what these positions give up in sheer competition, they make up for it in the amount of leg-work and effort that applicant needs to make to initiate the process. Often, you may have to write to several faculty in the practice, in multiple practices, in more than one hospital and all over the state. There are programs and doctors who do wish to teach and are willing to take on observers – its just a matter of reaching out to them
3. Pre-op clinics (internal medicine): This is not to say that observerships in medicine are any easier than those in anesthesia, observerships are difficult to come by for international physicians period. There are many more general internists and possibly family physicians who may spend a portion of their work week doing pre-op clinics. Many places run these clinics in conjunction with Anesthesia team but the experience is similar. Patients with complex medical history going in for elective surgery are assessed for preoperative risk analysis and perioperative complication reduction
4. Emergency medicine rotation: This may benefit those interested in anesthesia (or EM or IM or even FM) by being exposed to common procedural techniques. As an observer due to strict hands off policy – you wont be able to do any procedures but the observer experience would still count. Intubations, central venous access catheter placements, cut-downs, arterial cannulation, pressor protocols etc are some common areas that may be worthwhile.
5. Simulation laboratories (Sim-lab): most major institutions have a simulation lab where life size human dummies can be practiced. These are not just blocks of wood or latex but highly sophisticated pieces of engineering. Fees may be required and access may be limited.
6. Anesthesia grand rounds and Anesthesia meetings: This is another avenue to tap if you are looking to enhance you CV with anesthesia related material. Also an opportunity to make connections with faculty and have brief informal discussions and exchange contact information.